HomeMy WebLinkAboutMortgage_Greene (2)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
�__ � FOR DEDUCTION FROM ASSESSED VALUATION �
• Sfate Fortn a3709 (R77 / 6-09)
, Presvibetl by Oepartmerd of Laml Gwemmer�l Fuunce
ie
wsrRUCnoNS:
b 6e filed in person or 6y mail with the CountyAUdROf or Counry Recorder of the county whe�e [he pioperty is located.
Frliig Dates: 7) Real Properry: Must !1e dunng the year for which Ne deduction is sought.
2) Mobile / Manufactured Homes not assessed as Real Properfy Must file dunng the tweNe (12) months
6efore March 31 o/each yearthe deduclion is sought.
See reverse
nppGm�rt (o
Counry Audimr
L�6unN Recorder
.o...ro..... � .
-�3—�� oo-boo.3o�0 �7c
A,sessed oF real poperry as d Mor�qa ge / Contraa "uWebtedness unpai0 as ot ortgage / Contraa uMe6tedness unpaid as d Is Ne appfiranf ihe sale
MazU i, aYmit year Marrh 1, a�rtent year ate of appfrcation legal w epuRade wme(?
(43,3/4-- ❑v� ❑r,o
If ro, what is his / her e�oct share of intniest? If ovmeE with someone other than spoux, irNrcate with whom
11 name on 2coN is dtlferent lhan Nat of aDP��4 �inte Eebw I5 the property in Question: Mnualty h55es5e0
' � Real Property ❑ Mnually AssesSed . . _
Name of mortgagee a conttaU seller
or hdOer O( mortgage
Address ot assignee (number eM saeeL my. slate. e+id ZIP code)
Dpes epdimn� o.vn property in any oNer II yes. what
counry m �ntliana? ❑ ves
❑ No
�
I I We certiry Gnder th�
owner I contracl buyer
�nanue (ownefz fNl name)
� � �
T
Dra�ti�er NO....��.........
Card NO. ....1� ���........
; � � Iv 3,31 � Lb
� v�r
❑ No
Za i �— i �— i p—
� /w�-1 � I �nry i���d/li^1J�V.n/ � I Date (monM.V / V ��/�
of perjury at the above aM foregoing infortnalion is W e and cortect and that the appiitant is a resident of Indiana arM
o2merrti ed pmperty on date application is filed.
antl sheet mY s1are,
exew:e0 Power o( Attomey w oy
Address of autlior'ved person (numbar aiM speet, ciry, sfate,
0
�ate (npnN.